Although numerous attempts have been mde to reattach and repair transected nerve fibers, all such methods have failed. For the last century, up until the time of the present invention, all attempts to repair transected nerve fibers, so that the previously transected nerve fiber allows the passage of nervous impulses, have been unsuccessful.
One of the main reasons for the failure of the prior art methods and apparatus to repair transected nerves is the tendency to apply traditional surgical techniques to the nerve fibers. Although these traditional surgical techniques have proven completely effective with tissues, these techniques fail when applied to an injured nerve. One of the basic reasons for inapplicability of traditional surgical techniques to nerve fibers is the fact that each neuron comprises a single cell extending from the cortex of the brain through the spinal cord to the particular extremity in which the nerve fiber is found. Since the neuron comprises only a single cell from one end to the other, traditional techniques relating to tissues which comprise a group of cells have proven to be totally inapplicable.
The present inability to repair transected nerves is becoming increasingly important when the advances in microsurgical repair of tissue are considered. Using advances in micro-surgery, severed arms and legs may now be fully reattached without rejection by the body defense mechanisms. However, in spite of these surgical advances, control over muscles contained within the previously severed limb are virtually totally lost, since present day surgical techniques are unable successfully to repair the severed nerves in order to allow the nervous impulses to be carried to the extremities.
In general, prior art techniques to repair severed nerves have failed due either to an attempt to draw the nerve ends together by the nerve end's epineurium sheath or by attempting to draw the entire nerve ends into juxtaposition using vacuum. Both of these methods have failed due to the structure and physical characteristics of the nerve.
In particular, when a nerve end is drawn endwise by its epineurium, the fascicles of bundles of nerve fibers contained within the epineurium withdraw from the severed end, like an arm pulling up inside a sleeve. As a result, when the epineuria on facing nerve ends are joined by suturing, repair is not realized since the fascicles of the nerve fibers have withdrawn away from the connected zone and are not reattached.
In an attempt to resolve this problem, the vacuum technique was developed. However, the drawing of the nerve ends towards each other using vacuum merely causes the protoplasm forming the nerve fibers to be sucked out into the vacuum line. As a result, successful repair is not realized.
These prior art techniques are exemplified in the following patents:
William E. Kuhn's U.S. Pat. Nos. 3,960,151 and 3,916,905 relate to open-ended tubes into which the respective severed ends of a sectioned nerve are drawn by a partial vacuum.
James R. Palma's U.S. Pat. Nos. 3,786,817 and 3,833,002 likewise show tubes having open ends into which the ends of the sectioned nerve are drawn in juxtaposition by vacuum.
Michael B. Collito's U.S. Pat. Nos. 3,254,650 and 3,316,914 show "plumbing union" type flanges for severed blood vessel ends which may be everted and secured to the flanges and then clamped in position for suturing or healing.
Anastomotic couplings are shown in Sparks U.S. Pat. No. 3,357,432, Zack U.S. Pat. No. 2,453,056 and Hardy U.S. Pat. No. 3,974,835, and a surgical clamp which squashes blood vessels flat for anastomosis is shown in Pearson's U.S. Pat. No. 2,796,867.
Therefore, it is a principal object of this invention to provide methods and apparatus which allows both portions of a severed nerve to be held and moved into endwise juxtaposition without disturbing the fascicles of the nerve.
Another object of the present invention is to provide methods and apparatus for repairing severed nerves which allow the nerves to be preserved prior to the repair procedure without degradation or degeneration of the nerve.
Another object of the present invention is to provide nerve holding means which incorporate in single unitary structures all necessary provisions for successfully repairing and reconnecting severed nerves.
Another object of the present invention is to provide a method and apparatus for repairing severed nerves wherein the severed nerve ends can be held in juxtaposed contacting relationship for several hours and can then be quickly and easily removed from the holding apparatus.
A further object of the present invention is to provide a method and apparatus for repairing severed nerves wherein the ends of the severed nerve can be optically viewed and adjusted in order to maximize reattachment of matched fascicles.
Other and more specific objects will in part be obvious and will in part appear hereinafter.